A new partnership between two nonprofit providers could expand hospice care services in North Texas as the state’s population of older adults continues to grow.
Forefront Living, a nonprofit senior living facility with more than 100 patients, will wind down its hospice care as the Visiting Nurse Association of Texas, or VNA, becomes its preferred partner for the service. VNA will also take over management of Dallas’ first independent, residential hospice care center.
“There's so many hospices in North Texas,” said Chris Culak, president and CEO of VNA. “Being larger, having a larger footprint, having a large reach, having the ability to talk to more people about the service that we provide, having that we're going to be one of the only nonprofits left in North Texas, it allows us to really have a greater reach.”
Texans over the age of 65 are the fastest growing age group, expected to increase 88% by 2050, according to an analysis by UT San Antonio. VNA leaders said the growing population of older adults is going to put more strain on the health care industry as the need for care like hospice increases.
VNA provides hospice and palliative care across 16 counties in North Texas to more than 300 patients. Palliative care focuses on comfort and quality of life of people with a serious illness – as does hospice, but it’s provided in the final weeks or months of life.
Forefront Living has offered services to the Dallas area for more than 40 years, including through Faith Presbyterian Hospice and an inpatient hospice services center at the T. Boone Pickens Center.
Culak said being able to take over the operation of Faith Presbyterian Hospice is going to create one of the largest nonprofit hospice organizations in the region, and potentially one of the largest in the state.
“This allows us to continue to offer that greater level of care to more people,” he said. “We'll be able to go out and provide…this opportunity to be on our hospice program to a broader audience in North Texas because we'll combining forces.”
Olivia Rogers, vice president and chief nursing officer at VNA, said studies show nonprofits can have several benefits for patients – like more patient visits and more intensive care in a person’s home.
“The other strength of a nonprofit is that we have the ability through very generous and long-term donors in DFW to raise money for services that the hospice benefit from Medicare just does not provide,” she said.
Reimbursement rates for programs like Medicare haven’t kept up with the cost of living or the rising cost of providing services, according to Rogers. She said it can be difficult to have adequate staffing or offer other services.
For example, VNA has been able to offer bereavement services and access to Child Life Specialists – health care professionals who help prepare, educate and support children and family members when someone they know is in hospice. Through its partnership with Forefront Living, Rogers said VNA will also be able to offer music therapy and massage therapy. She said VNA hopes to expand services even more.
“VNA kind of has a history of doing what's hard,” Rogers said. “One of those things includes providing pediatric services in North Texas. This is very rare. Most hospices do not have a pediatric arm. We wish there were more because there really is a gap in care.
"So in this partnership, as we grow, we're able to hopefully expand through adding quality staff.”
Rogers said the partnership could also help expand access to palliative and hospice care in rural areas. Despite the large number of providers in areas like Dallas, Rogers said the rural counties that VNA covers are still underserved.
“There is still a lack of adequate coverage in rural areas because they're hard to get to,” she said. “It's very expensive… We're making visits. We're driving out to these really rural areas, as VNA, to provide services. That's always been a mission for us. That will always be. But adding the staff that we need will allow us to continue to expand our rural care.”
In addition, Rogers said VNA will continue to offer inpatient hospice care, even while the T. Boone Pickens Center is temporarily closed. The center is expected to reopen under VNA leadership in early summer, but Rogers said VNA has contracted with other senior living facilities to offer inpatient care in the meantime.
Forefront Living patients will continue to have an option for who provides their hospice care, but Rogers said the organization has already taken steps to make sure patients have a smooth transition.
“If they choose VNA Hospice, we're trying to bring them over with their team so that they don't experience any stress [and we] eliminate as much change as possible just for their peace of mind and continuity of care.”
Culak said the partnership will help add stability at a moment when providers are facing increasing challenges due to policy changes to significant programs like Medicaid and Medicare.
“More organizations out there that are struggling because of the regulations or struggling because of inadequate support from the health insurance side and so forth,” Culak said. “Having this partnership only strengthens our ability to continue to grow, continue to provide the care that we believe in, and really it allows us to reach more people.”
Abigail Ruhman is KERA’s health reporter. Got a tip? Email Abigail at aruhman@kera.org.
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